| Joshua D Smith And Associates Inc | |
|
540 3rd St Idaho Falls ID 83401 | |
| (208) 529-3719 | |
| (208) 535-0942 |
| Full Name | Joshua D Smith And Associates Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 540 3rd St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Brenda Lee Emery (OWNER/DIRECTOR) |
| Authorized Official Contact | 2086817133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joshua D Smith And Associates Inc 540 3rd St Idaho Falls ID 83401-3953 Ph: (208) 529-3719 | Joshua D Smith And Associates Inc 540 3rd St Idaho Falls ID 83401 Ph: (208) 529-3719 |
| NPI Number | 1144351461 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 06/13/2018 |
| Medicare PECOS PAC ID | 9739326547 |
|---|---|
| Medicare Enrollment ID | O20130516000000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144351461 | NPI | - | NPPES |
| 002678900 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Wendy F Swope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962522409 PECOS PAC ID: 5092800672 Enrollment ID: I20070927000204 |
| Provider Name | Larry A Calabro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558704965 PECOS PAC ID: 0446499966 Enrollment ID: I20130613000349 |
| Provider Name | Linda H Snell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144503426 PECOS PAC ID: 4183868680 Enrollment ID: I20130924000523 |
| Provider Name | Ethan W Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144657966 PECOS PAC ID: 7315178118 Enrollment ID: I20140319002311 |
| Provider Name | Corene R Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003188897 PECOS PAC ID: 4587883749 Enrollment ID: I20140919002390 |
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